Abstract: TH-PO933

Early Initiation of ACE Inhibitors in the Post Renal Transplant Period: A Study from a State Run Tertiary Care Centre

Session Information

Category: Transplantation

  • 1701 Transplantation: Basic and Experimental

Author

  • L, Umesh, INSTITUTE OF NEPHROUROLGY, BANGALORE, KARNATAKA, India
Background

Angiotensin converting enzyme inhibitors (ACEI) comprise drug class, which inhibit the effects of angiotensin II by blocking the synthesis of same. Angiotensin converting enzyme inhibitors (ACEI) are well documented to be potent anti-hypertensives with renoprotective effects but are grossly underutilized in renal transplant recipients. However, these drugs have been reported to cause elevated potassium and creatinine levels in some renal transplant patients. There have been no reports of prospective studies of ACEI in renal transplant patients in the early posttransplant period. The purpose of this study is to assess the safety of an ACEI class, when started in early posttransplant period.

Methods

This study is a Prospective observational study. We reviewed 78 kidney transplant patients during the period of January 2012 to march 2017 at our institution. 64 patients were initiated on ACEI therapy within a month of post- transplant. Patients were considered to be enrolled when they met the following criteria: Declining serum creatinine, improving urine output and serum potassium < 5.5 mEq/L. Exclusion criteria: anaphylaxis to ACEI, use of ACE or ARB for treatment of posttransplant erythrocytosis and serum potassium >5.5 mEq/L.

Results

64 Patients were studied, 53(83%) were male and 11(17%) were females. Mean age was 32±15 years (12-56). Minimum duration of follow up was 6 months. For each patient haemoglobin, serum creatinine and potassium levels were analyzed at the beginning of ACE inhibitors and at the end of the first, third, sixth month. Average potassium levels, hemoglobin levels did not differ significantly between groups and were in normal clinical ranges. While incidence of graft failure did not differ, death with functioning graft was lower in the ACEI group.

Conclusion

ACEI can be used successfully in post-renal transplant with beneficial long term impact on renal function. There is need for further randomized controlled studies to see the effect of ACEI on Graft function and its survival.

Funding

  • Government Support - Non-U.S.